Data from observational studies have shown that everolimus is an effective treatment for patients with metastatic insulinoma and refractory hypoglycemia.57-59 In addition, inhibition of the mTOR pathway was shown to decrease insulin secretion in patients suffering from insulinomas.57-59 Preliminary published data suggest that RLT can prove successful in further controlling severe hypoglycemia in malignant insulinomas.60 Here, INS is linked to pancreatic insulinoma.